• Title/Summary/Keyword: Bowel management

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A Study on the Level of ADL in Community Dwelling Elderly Registered in a Public Health Center (일개 시 보건소에 등록된 재가노인의 일상생활 동작수행 정도에 대한 조사연구)

  • Kim, Keum-Ja;Jang, Hyo-Soon;Yoon, Jin;Ko, Sun-Hwa;Lee, Eun-Hui
    • Research in Community and Public Health Nursing
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    • v.13 no.2
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    • pp.332-342
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    • 2002
  • Purpose: The purpose of this study was to assess the level of activities of daily living (ADL) in a group of community dwelling elderly. Methods: The subjects were 100 low-income elderly registered in a public health center. The data were analyzed using the SPSS/PC program. Results: The results were as follows: 1. The basic ADLs of the subjects were scored at 7 levels, and the mean score was 6.24 out of 7 points. The subjects did not necessarily require help from others, but might have needed more times or instrumental assists to perform ADLs. The lowest ADL score was reported on walking up to the stairs (5.05), for which the subjects did not need physical assistance, but needed a certain degree of supervision. The highest score was reported on self eating (6.74), followed by bowel management (6.60). 2. The mean IADL score of the subjects was 1.77 out of 4 points. indicating that the subjects were very independent in performing IADLs, without help from others. 3. In relation to general characteristics, the level of ADLs of the subjects was significantly different by age (F=6.65, P=.000), main activities (F=6.36, P=.001), perceived health status (P=4.66, P=.012), educational background (F=4.64, P=.03), marital status(F=4.62, P=.005), and major household income (F=4.15, P=.002). 4. The subjects' level of IADLs in relation to their general characteristics was significantly different by perceived health status (F=8.08, P=.001), major activities (F=7.33, P=.000), age (F=6.18, P=.000), family context (F=3.53, P=.018), religion (F=3.10, P=.019), marital status(F=2.62, P=.055), and major household income (F=2.31, P=.049).

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Feasibility Study of Early Oral Intake after Gastrectomy for Gastric Carcinoma

  • Jo, Dong-Hoon;Jeong, Oh;Sun, Jang-Won;Jeong, Mi-Ran;Ryu, Seong-Yeop;Park, Young-Kyu
    • Journal of Gastric Cancer
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    • v.11 no.2
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    • pp.101-108
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    • 2011
  • Purpose: Despite the compelling scientific and clinical data supporting the use of early oral nutrition after major gastrointestinal surgery, traditional bowel rest and intravenous nutrition for several postoperative days is still being used widely after gastric cancer surgery. Materials and Methods: A phase II study was carried out to evaluate the feasibility and safety of postoperative early oral intake (water intake on postoperative days (POD) 1-2, and soft diet on POD 3) after a gastrectomy. The primary outcome was morbidity within 30 postoperative days, which was targeted at <25% based on pilot study data. Results: The study subjects were 90 males and 42 females with a mean age 61.5 years. One hundred and four (79%) and 28 (21%) patients underwent a distal and total gastrectomy, respectively. The postoperative morbidity rate was within the targeted range (15.2%, 95% CI, 10.0~22.3%), and there was no hospital mortality. Of the 132 patients, 117 (89%) successfully completed a postoperative early oral intake regimen without deviation; deviation in 10 (8%) due to gastrointestinal symptoms and in five (4%) due to the management of postoperative complications. The mean times to water intake and a soft diet were $1.0{\pm}0.2$ and $3.2{\pm}0.7$ days, respectively, and the mean hospital stay was $10.0{\pm}6.1$ days. Conclusions: Postoperative early oral intake after a gastrectomy is feasible and safe, and can be adopted as a standard perioperative care after a gastrectomy. Nevertheless, further clinical trials will be needed to evaluate the benefits of early oral nutrition after upper gastrointestinal surgery.

Clinical Analysis of Adhesive Ileus in Children (소아의 유착성 장폐쇄증에 대한 임상적 고찰)

  • Lee, Jong-Jae;Youn, Hyun-Jo;Jeong, Yeoun-Jun;Kim, Jae-Chun
    • Advances in pediatric surgery
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    • v.7 no.2
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    • pp.118-125
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    • 2001
  • The effectiveness of operative and non-operative management for postoperative adhesive ileus in children has been discussed. This study reviews the clinical characteristics and the treatment consequences of adhesive ileus in our institution. Department of Surgery of Chunbuk National University Hospital, retrospectively. A total of 62 cases of post-operative small bowel obstruction treated between January 1975 and December 1998 under the 15 years of age are included in this study. The patients were divided into two groups, operative(n=26) and non-operative(n=36) groups. The prevalent age was between 11 and 15 years(28 cases; 45.2 %), and the most common previous operation was appendectomy(28 cases; 45.2 %). The most common operative procedures were adhesiolysis(17 cases; 65.4 %). The interval between admission and operation was 1 day in 11 cases(42.3 %). The most common site of adhesion was the ileum in 13 cases(50.0 %) and band constriction was the most frequent pattern(8 cases; 30.8 %). Intestinal resection was significantly high in delayed operations of more than four days, in the patients with three or more classical signs of strangulation(fever, tachycardia, leukocytosis, abdominal pain, rebound tenderness), and in the cases of complete obstruction on plain abdomen film(p < 0.05). In conclusion, operation should be considered in cases with three or more signs of strangulation, no clinical improvement for over four days of conservative treatment, and signs of complete obstruction on plain abdomen film during the observation periods.

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Simultaneous Analysis of Six Compounds in Yijin-tang by HPLC-PDA (HPLC-PDA을 이용한 이진탕 중 6종 성분의 동시분석)

  • Kim, Seong-Sil;Kim, Jung-Hoon;Shin, Hyeun-Kyoo;Seo, Chang-Seob
    • Herbal Formula Science
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    • v.21 no.1
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    • pp.71-79
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    • 2013
  • Objectives : Yijin-tang has been used in the treatment of gastrointestinal diseases such as irritable bowel syndrome, gastritis, and gastric ulcer. In this study, a high-performance liquid chromatography (HPLC) method was established for simultaneous analysis of six compounds, liquiritin, glycyrrhizin, hesperidin, 6-gingerol, homogentisic acid, and 3,4-dihydroxybenzaldehyde in Yijin-tang, a traditional Korean herbal medicinal preparation. Methods : A Gemini C18 column was used for the separation of six constituents at $40^{\circ}C$. The mobile phase using gradient elution consist of two solvent systems, 1.0% acetic acid in water (A) and 1.0% acetic acid in acetonitrile (B). The flow-rate was 1.0 mL/min and injection volume was $10{\mu}g$. The detector was a photodiode array (PDA) detector set at 254 nm and 280 nm. Results : The calibration curves of six compounds showed good linearity in various concentration ranges ($R^2{\geq}0.9997$). The limits of detection (LOD) and limits of quantification (LOQ) were 0.028-$0.192{\mu}g/mL$ and 0.093-$0.540{\mu}g/mL$, respectively. The RSD (%) of the intra and inter day validations were 0.03-0.84% and 0.05 -1.00%, respectively. Recovery was 96.14-01.90% and RSD (%) was less than 1.5%. Conclusions : The established simultaneous analysis methods will help management to improve the quality of Yijin-tang.

Clinical Characteristics of Children Needing Inpatient Treatment after Failed Outpatient Treatment for Fecal Impaction

  • Sinha, Amrita;Mhanna, Maroun;Gulati, Reema
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.3
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    • pp.196-202
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    • 2018
  • Purpose: Treatment of chronic constipation and fecal impaction is usually outpatient and requires high or frequent doses of laxatives. However, there are children who fail outpatient treatments, sometimes repeatedly, and are ultimately hospitalized. We sought to compare the characteristics of the children who failed outpatient treatment and needed inpatient treatment vs those who achieved success with outpatient treatment, in an effort to identify attributes that might be associated with a higher likelihood towards hospitalization. Methods: In this retrospective cohort study, we reviewed the medical records of all patients aged 0 to 21 years, with chronic functional constipation and fecal impaction seen in the pediatric gastroenterology clinic over a period of 2 years. Results: Total of 188 patients met inclusion criteria. While 69.2% were successfully treated outpatient (referred to as the outpatient group), 30.9% failed outpatient treatment and were hospitalized (referred to as the inpatient group). The characteristics of the inpatient group including age at onset of $3.6{\pm}3.6years$ (p=0.02); black ethnicity (odds ratio [OR] 4.31, 95% confidence interval [95% CI] 2.04-9.09); p<0.001); prematurity (OR 2.39, 95% CI 1.09-5.26; p=0.02]; developmental delay (OR 2.20, 95% CI 1.12-4.33; p=0.02); overflow incontinence (OR 2.26, 95% CI 1.12-4.53, p=0.02); picky eating habits (OR 2.02, 95% CI 1.00-4.08; p=0.04); number of ROME III criteria met: median 4, interquartile range 3-5 (p=0.04) and $13{\pm}13.7$ constipation related prior encounters (p=0.001), were significantly different from the outpatient group. Conclusion: Identification of these characteristics may be helpful in anticipating challenges and potential barriers to effective outpatient treatment.

Clinical Diagnosis and Its Medical Managements from Patients with Gastrointestinal Diseases (위장관 질환자의 임상진단과 치료방법)

  • 김재웅
    • The Korean Journal of Food And Nutrition
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    • v.10 no.2
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    • pp.186-192
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    • 1997
  • Endoscopic diagnosis and medical management from K43 and C45 patients, whose sex, occupation, character and life patterns are quite different each other, were discussed. The K43 was patient with erosive gastritis, which may caused by maldietary habits and life stresses. Although the effective drugs such as H2-receptor antagonists with atacids, H+/K+-pump inhibitors, prokinetics, colloidal bismuth, and sucralfates, were administrated for long time, symptomatic relief of abdominal pain was not improved. The tests of clinical phathology and abdominal sonogram were normal, visceral hypersensitivity was appeared from barostat test of stomach. However C45 had taken headache during every day life, and endoscopically confirmed as a gastric·duodenal ulcer patiant, which may caused by chronic use of NSAIDs. The her ulceric symptoms were suppressed from active stage to healing stage by using combination therapy for H. pylori with traditional antipeptic ulcer drugs, where as amitriptyline was administrated to the K43 but not effective. Nonulcer dyspepsia and irritable bowel syndrome is pooly defined, and affect about 15% of the population annually in U. S. A. but don't seek medical care. Author would like to point out that statistics for visceral pains are absent in Korea.

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Pneumatosis Intestinalis Complicated by Pneumoperitoneum in a Patient with Asthma

  • Choi, Joon Young;Cho, Sung Bae;Kim, Hyun Ho;Lee, In Hee;Lee, Hea Yon;Kang, Hye Seon;Lee, Hwa Young;Lee, Sook Young
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.5
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    • pp.219-222
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    • 2014
  • Pneumatosis intestinalis (PI) is a very rare condition that is defined as the presence of gas within the subserosal or submucosal layer of the bowel. PI has been described in association with a variety of conditions including gastrointestinal tract disorders, pulmonary diseases, connective tissue disorders, organ transplantation, leukemia, and various immunodeficiency states. We report a rare case of a 74-year-old woman who complained of dyspnea during the management of acute asthma exacerbation and developed PI; but, it improved without any treatment.

Acalculous Cholecystitis Following Multiple Trauma with Fractures (골절을 동반한 다발성 외상 환자에서 발생한 비결석성 담낭염)

  • Kim, Ki Hoon;Kyung, Kyu Hyouk;Kim, Jin Su;Kim, Kwan U;Kim, Woon-Won;Kim, Ji Wan
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.203-208
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    • 2012
  • Purpose: The purpose of this study is to investigate the incidence of acalculous cholecystitis after multiple trauma with fractures and to analyze the characteristics of cholecystitis. Methods: We performed a retrospective study of multiple trauma patients with fractures between April 2010 and April 2012. Sixty- nine patients were identified, and the average age was 46.8(range: 15-74) years. Data were collected regarding associated injury, injury severity score (ISS), the diagnosis time after trauma, diagnostic tool, and management Results: There were three cases(4.3%) of cholecystitis among the 69 cases, and cholecystitis was diagnosed an average of 20.7(range: 8-33) days after injury. Two patients complained of abdominal pain at diagnosis, but the other patient who had undergone surgery for small bowel perforation at the time of the injury had no abdominal pain. All three patients had abnormal liver function tests (LFTs) at diagnosis. The cholecystitis was confirmed with ultrasonography or computed tomography, and all cases were acalculous cholecystitis. At first, percutaneous transhepatic gallbladder drainage was performed; then, laparoscopic cholecystectomy (LC) was tried an average of 12(range: 11-13) days later. An laparoscopic cholecystectomy was successfully done in only one case, the other cases being converted to an open cholecystectomy due to severe inflammation. Conclusion: The incidence of acaculous cholecystitis was 4.3% after multiple trauma with fractures. We should consider cholecystitis in patients with abdominal pain, fever and elevated LFTs after multiple trauma.

The Research on the Factors Influenced on the Cosmetologists' Health of Digestive System (헤어 미용사의 소화기계 건강에 영향을 미치는 요인에 관한 연구)

  • An, Hyeonkyeong
    • Journal of Fashion Business
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    • v.19 no.4
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    • pp.37-56
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    • 2015
  • This thesis aimed to determine the effecting factors(eating pattern, working condition, stress, health care) that help maintain the health of the cosmetologists' digestive system and the diseases involved (acid reflux, indigestion, gastritis, constipation & diarrhea). The research methods included survey and statistical analysis. The survey was conducted on 242 cosmetologists from August 30 to October 30 2014. The data analysis included frequency, cross table, ${\chi}^2$-test, and regression with SPSS(V. 14). The results were as follows ; (1) The cosmetologists' health of digestive system and eating pattern are related. Regular and enough meal times cause less digestive disease. Acid reflux, indigestion, gastritis, constipation and diarrhea are differently related with the type of usual eating pattern, especially, instant food is not good for digestive health. (2) The cosmetologists' health of digestive system and working condition are related. Longer daily working hours and exposure time to chemical odors are more likely to be associated with digestive diseases; whereas, longer time of standing and talking with colleagues are less likely to be associated with digestive diseases. (3) The cosmetologists' health of digestive system and stress are related. Headache, boredom, conflict of pay and compensation, and insomnia are not good for digestive health. (4) The cosmetologists' health of digestive system and health care are related. Periodical medical examination and usual body stretching are correlated with digestive diseases; whereas, people who do regular exercise and bowel movement are less likely to have digestive diseases.

Congenital Bochdalek hernia: report of 4 cases (선천성 Bochdalek hernia4례 보고)

  • Jin, Jae-Gwon;Park, Ju-Cheol;Yu, Se-Yeong
    • Journal of Chest Surgery
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    • v.15 no.4
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    • pp.432-439
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    • 1982
  • Congenital posterolateral diaphragmatic hernia [Bochdalek hernia] is the result of a congenital diaphragmatic defect in the posterior costal part of the diaphragm in the region of the tenth and eleventh ribs. There is usually free communication between the thoracic and abdominal cavities. The defect is most commonly found on the left [90%], but may occurs on the right, where the liver often prevents detection. The male to female ratio is 2:1. Owing to the negative intrathoracic pressure, herniation of abdominal contents through the defects occurs, with resultant collapse of the lung. Shifting of mediastinum to the opposite side and compression of the opposite lung occurs. Most often these hernias are manifestated by acute respiratory distress in the newborn. A second, but less well recognized, group of patient with Bochdalek hernia survive beyond the neonatal period, usually present at a later time with "failure of thrive, intermittent vomiting, or progressive respiratory difficulty. " The diagnosis can often be made on clinical ground from the presence of respiratory distress, absence of breath sounds on the chest presence of bowel sounds over the chest . Roentgenogram of the chest confirm the diagnosis. Obstruction and strangulation have been reported but are rare. Treatment consists of early reliable identification of these congenital diaphragmatic hernia with high risk and surgical repairment. and postoperative pharmacological management with extracorporeal membranous oxygenation [=ECMO] support in the period of intensive care. On the surgical approach, for defects on left side, an abdominal incision is preferred, because of the high incidence of malrotation and obstructing duodenal bands. In the neonate, the operative mortality may be appreciable, but, later repair almost always is successful. During the period from 1972 to 1982, 4 cases of congenital Bochdalek hernia were experienced at the Kyung-Hee University Hospital.

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